Discussions By Condition: I cannot get a diagnosis.

Fainting;slurred speech;contractors

My mother has had a few episodes of this. She will faint, wake up with slurred speech and contractors of all limbs. She has an appt. setup with a neurologist in 2 months, but til then, we're worried. it sounds like a stroke, but they don't know, because within an hour, she'll be back to normal. she's starting to have them more frequently, but she isn't having the full attack. she won't pass out, but she'll get half-way contracted limbs. Any ideas?

5 Replies:

2 months is WAY too long IMH. one of the worst case scenarios would be that she is having some transitory cerebral ischemic attacks which are BAD since ultimately lead to a stroke. she should get a CT, at least, right away.what country are you from?

Okay, cerebrovascular incidents or strokes rarely cause syncope or fainting to occur. Your mother's symptoms are more related to something called Myoclonic Epilepsy. An increase in symptoms is very common among persons with epilepsy and the refractory period that you describe is somewhat diagnostic as well. It's doubtful that she's actually fainting in the traditional sense, but rather becoming obtunded from the epileptiform activity in the brain during the event. My suggestion here is to maintain your appointment with your neurologist and if an epileptologist is available sooner, you should obtain an appointment and seek to have an EEG performed. If there's evidence of epileptiform activity, an MRI and other tests can be performed to try and isolate the cause, although in some instances, the disorder is ideopathic in nature. Eight weeks is also a bit long to wait and unless you're in a location where more responsive access is unavailable, I would seek a different physician. If she does have epilepsy, then it's quite treatable. You should also know that the onset of epilepsy in older persons is more common than one might expect. There are several other causes for such symptoms, so it's best to seek the soonest appointment available to rule out certain conditions. Best regards, J Cottle, MD

Thanks. She has kept regular appointments with her normal physician and they've done xrays and similar, but they've ordered an EEG. Since we live in a smaller city, the neurologists here don't have a good name for themselves. She saw one for quite a while and he couldn't tell her what was wrong, so she made an appointment with a neurologist at Vanderbilt in Nashville, TN for an EEG. I hope this shows something.

Vanderbilt is an excellent choice. Dr. Bob McDonald would be a first choice and he's also the chair of the department. If anyone can locate the problem, he'd certainly be the one to do it. All of the faculty, however, are excellent and any one of them could provide you with an excellent evaluation and treatment plan. Best regards, J Cottle, MD